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Author Topic: Obamacare Predictions for May 2015
JoshCrow
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It's no fun to be proven wrong, but the wise at least try to make it an educational moment.

I am appreciative of Greg's efforts here and I hope to see more threads like it. It is easy to have convictions, hard to have the courage to back them up, and far harder to have the humility to change them.

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Seriati
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quote:
Originally posted by NobleHunter:
quote:
It is in fact a common failing of socialized medicine that treatments, particularly expensive ones, are not available when medically called for.
The reverse is that in private systems treatments, particularly expensive ones, are inaccessible when medically called for. While they can become available in socialized system whether by waiting list (problematic) or by prioritization (better but still problematic), the more straightforward means of improving accessibility will just run into the availability problem anyways. So why not just skip the accessibility problem? I mean aside from philosophy of government stuff.
Because what you stated is not an accurate summation of the difference. Private treatment systems have a history of bringing the price down on treatments that are medically too expensive initially over time. That's fundamentally different from the socialist default. The risk with capitalist systems is of overallocation of resources to expensive process not of underallocation. Any expensive and thus profitable treatment will always become more available overtime in the private system, and only might do so in the socialist system.

Of course the inverse can be true as well, with socialist systems widely distributing less profitable/expensive treatments that the private system ignores.
quote:
Originally posted by TomDavidson:
quote:
Frequent check-up visits is a measure of access level.
Not in the way it's usually meant when people talk about "access."
I can't help it if you want to argue about illogical thought.
quote:
Most other countries do frequent wellness visits with nurses or corner clinics, which provides an equivalent quality of care for much cheaper. America's one of the few countries that expects a MD for a checkup.
Which is fair enough, but it goes directly to the original claim I made that the quality level would have to reduce or the price increase. I'm not going to debate it again, but there is no real question that check-ups with doctors are superior, there's only a reasonable question about whether they are enough superior to justify the cost.
quote:
Originally posted by GregDavidson:
Change of pace here - how do people feel about the predictions that they made (or about the ones that you saw being made)?

I still think it was silly for anyone to make specific predictions other than as a lark.
quote:
How many people were surprised? Does anyone have any different thoughts about the effectiveness of Obamacare as a policy in light of how things have progressed in the 18 months since the initial predictions that many of us made?
Not surprised. The only surprising thing to me was the level of unconcern as the timing of the implementation was deliberately manipulated.

Nothing so far has changed my view that this policy is going to cost way more than advertised (both in real cost, but also in price); that it fundamentally reduces our civil rights that we can now be forced to buy commercial products; and that ultimately its going to lower treatment levels. I think it's also evident that the medical record consolidation requirements expose health records to real risks of misappropriation and misuse.

It's also shown (not alone grant you) that we need a new process for the approval of regulations. Congresses role in passing and implementing law has been completely subverted by expansionist regulatory actions by unelected bureaucrats. Basically, Congress is now barred from setting the terms of our laws, unless they can get a supra-majority and either override the President or get executive consent. In such a circumstance it was intended there would be no law, not that a bureaucrat could implement whatever the courts don't prevent them from doing.

I think no regulation should become valid, unless it receives an affirmative vote in Congress, but I don't mind them doing it in bulk if they choose.
quote:
Oh, and the uninsured rate is down to 11.4% according to Gallup
You might ask in a country where it's a violation to not have insurance its still that high.
quote:
Now why was it that there was such an intensity of posting on this topic a year ago, while so little now?
No one listens anymore. The sides are set and no longer convincible. So what is there to be intense about?

I mean honestly, we're reading some of the same reports, but you're concluding the half empty glass proves the law is working, and I'm concluding it's a demonstration of it failing. And everyone is being intentionally manipulated by misleading statistics, which makes it trivially easy to "validate" your own beliefs and thereafter to ignore contrary evidence.

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Greg Davidson
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Welcome back Noel C,

While you were gone, we took a comprehensive look at the predictions we all made on Obamacare. Care to see how accurate your predictions were? More importantly, will you change your world view in any way to address the significant differences between what you thought would happen and what did happen?

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noel c.
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Please quote my prediction.
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noel c.
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Ah, I see that you listed a few at the top of this page.

This is the year we begin to see the IRS lay into non-participating tax payers in a serious way. "General satisfaction" levels should begin coming in at that point, along with the increases in premium, or reduction in services, under employment plans.

I can speak anecdotally on the latter. A liberal friend was utterly exasperated by his increased coverage costs, and wished he had signed up under Utah's exchange. He raved that an unemployed acquaintance paid only $30/month for far better coverage. Like most liberals he seems to believe lunches are free.

Last year I personally had $58,000 worth of knee, and shoulder surgery that I have put off for more than 30 years. For me, Obama care was the supreme motivator as I hate hospitals, knives, and needles. It took a piece of legislation like the UCA to persuade me to finally bite the bullet before my health care became more "affordable".

I am glad I did. It is surprising how accustomed to low grade pain we can become. I give Barry credit for that.

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Greg Davidson
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Noel, if you look at May 26 you can see my first of ten posts regarding the 700 pages of material in this thread. Using a common standard for what is a prediction, you made 7 predictions and were wrong on 6 (all about how Obamacare would function), I judged your political prediction that Obamacare would hurt red state democrats to be true.

But you were clearly wrong about how it worked. Do you ever ask yourself if your worldview is true, why did things turn out so vastly differently from your predictions?

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noel c.
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Greg,

"It", whatever it may ultimately be, has not been fully implemented. Justice Roberts only recently cleared the path for comprehensive federal subsidy.

Now the show begins, and "it" will not proceed unapposed, or unmodified as has been the pattern since its inglorious christening under Sabellius. "It" came into being through non-bipartisan maneuvering, but it will likely die a death of a thousand cuts through bi-partisan action beginning with the medical device tax. :

http://www.medpagetoday.com/Washington-Watch/Washington-Watch/52274

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Greg Davidson
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Noel, I asked very specifically for predictions as of a finite time (May 2015). You offered your predictions with what appeared to be a great deal of certainty. For example, you scoffed at government reporting and asserted only an additional 2-3 million people would be covered. You were wrong.

Have you learned anything that will make your analyses and predictions more accurate in the future, or is your position and worldview independent of what actually happens in the real world?

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noel c.
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"For example, you scoffed at government reporting and asserted only an additional 2-3 million people would be covered. You were wrong. "...

I still scoff at government reporting, and the nature of paid "coverage". Show me evidence of added efficiency. If you cannot, this is just another liberal give-away destined to collide with economic reality... unless, of course, your opinion is "independent of" economic reality.

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Greg Davidson
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Noel, it appears that your ideology blinds you so much that you cannot even recognize or acknowledge that you made wildy wrong claims. Do the other arguments you make similarly suffer from an inability to recognize or acknowledge error?

And you errors are not just an assertion on my part - they are clearly documented in your own words:

quote:
there is a net zero gain in people covered by "private" insurance when those being kicked off of their plans are factored in, and roughly 1\3 of new UCA "enrollees" have been placed on the Medicaid roll. (noel c 3/26/2014)

quote:
Barry's enrollment count is encrypted buy their own incompetence (unless they are simply lying), but actual enrollment is a net negative at best if unpaid policies, and termination of private policies are factored in. Medicaid accounts for nearly 1/3 of the "six million" number.(Noel c. 3/29/2014)
quote:
Kathleen Sabelius claims that she does not know what the actual enrollment numbers are, nor does she know who how many included in her estimate have paid their first premium. I don't really believe her (given the veracity of her past reports to congress, why should we?), but why are you confident in your sources numbers? They look thoroughly cooked to me, by at least a factor of five. (noel c 3/29/2014)
quote:
Noel c.: Of the 48 million total uninsured that the UCA was supposed to take a chunk out of, I suspect we will still end up with 45-46 million uninsured as of the close of enrollment... (noel c. 4/1/2014)
Greg: Excellent - thank you for your prediction. We shall document either your victorious prognostication, or your significant level of error

quote:
By the time all individuals who had existing health care coverage are factored in, it is quite possible "2 million" will be the correct number. This ridiculous "20 million newly insured" is a patent lie promoted by surrogates who the administration can disclaim at the end of the day. I think it is reasonable to double the Rand number... (allow ambiguity the benefit of a doubt). The UCA is still an unmitigated disaster, and not primarily because it failed, but because it dismantled some highly valuable health-care delivery infrastructure. (noel c. 4/1/2014)

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Greg Davidson
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The latest Kaiser Family Foundation indicates that average 2016 Obamacare premium increases were 3.1% (in 13 major cities in different states where all premium information was available)

link

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Rafi
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Here's one to check

quote:
"We will start," Obama said back in 2008, "by reducing premiums by as much as $2,500 per family."
The result:
quote:
Since 2008, average family premiums have climbed a total of $4,865.
[Exploding]
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D.W.
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But Rafi, he did say "by as much as" not "on average". [Wink] As long as SOME family got that reduction, he was spot on...
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Wayward Son
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Besides, based on history, what would have been the average premium rise in the last 7 years (since 2008)?

$7,365? [Smile]

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Seriati
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quote:
Originally posted by Wayward Son:
Besides, based on history, what would have been the average premium rise in the last 7 years (since 2008)?

$7,365? [Smile]

Which is why I've been pointing out the absurdity of using "premiums" as the measure, rather than the entire cost. I was reading an article yesterday that attributes much of the wage stagnation over the last few years to employers spending more on their portion of the health care cost increases. When you add the subsidies and all the new taxes that were added, the idea that what you've shown is a lower rate of cost growth than would otherwise have occurred gets strained.

When you look at the FACT that the economy slowed over all you realize that citing to it is nothing but an illusion, and very likely just misleading.

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Rafi
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quote:
Originally posted by Wayward Son:
Besides, based on history, what would have been the average premium rise in the last 7 years (since 2008)?

$7,365? [Smile]

Now said $2500 decrease you are convinced he really meant a $7365 increase. [DOH]
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Greg Davidson
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quote:
Which is why I've been pointing out the absurdity of using "premiums" as the measure, rather than the entire cost. I was reading an article yesterday that attributes much of the wage stagnation over the last few years to employers spending more on their portion of the health care cost increases. When you add the subsidies and all the new taxes that were added, the idea that what you've shown is a lower rate of cost growth than would otherwise have occurred gets strained.

When you look at the FACT that the economy slowed over all you realize that citing to it is nothing but an illusion, and very likely just misleading.

Seriati, overall health care cost growth in the US has slowed under Obama. And economic growth has improved dramatically from the terrible state it was in when Obama came into office. So, what is the evidence for your "FACT that the economy slowed over all"?
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Greg Davidson
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Rafi, if you ever acknowledge how wrong your previous assertions were on this very thread, you may recover a shred of credibility to make new assertions. But why should anyone trust a person on this site who repeatedly makes wrong statements and never owns up to them?
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Wayward Son
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quote:
Now said $2500 decrease you are convinced he really meant a $7365 increase. [DOH]
Please re-read my original sentence, Rafi. You have completely misinterpretated it and missed my point.

[ September 25, 2015, 11:00 AM: Message edited by: Wayward Son ]

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cherrypoptart
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I just looked up Obamacare plans in Texas for a family of four with two teenagers with no subsidy so an example of one I would have to buy is:

Bronze HSA 100®
UnitedHealthcare Life Insurance Company
$941.68
per month
Network: UnitedHealthcare Choice
Deductible: $12,600
Coinsurance: 100/0
Estimated Premium: $941.68
Meet the deductible, no further out-of-pocket expense.

Affordable Care Act compliant plan.

Only available during Open Enrollment and Special Enrollment periods (must meet criteria of a Qualifying Life Event to be considered "Special Enrollment").

-----------------------------------------

So whatever prediction I made about Obamacare, and it was an off the wall one anyway, this reality is much, much worse.

How is this the least bit affordable?

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TomDavidson
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It's not. That's a plan for idiots.
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cherrypoptart
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What's a good plan?

In Texas, not eligible for subsidies, 2 teens and 2 adults in their 40s. Non-smoking. I'm open to suggestions.

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cherrypoptart
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What's a good plan?

In Texas, not eligible for subsidies, 2 teens and 2 adults in their 40s. Non-smoking. I'm open to suggestions.

If anyone is good at this stuff, I'd also be interested in knowing what is the number I use with the IRS to determine if the plan is a certain percentage of income to determine if I have to pay the penalty or not. What's the plan dollar amount to use there.

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TomDavidson
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It's by ZIP code nowadays. What's your ZIP?
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TomDavidson
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I plugged in Houston. Almost every single plan in that area is better than the one you've described, so I'm clearly guessing in the wrong area. If you let me know your region and how you expect to use the doctor -- and if you're looking for disaster coverage or actually intend to see a doctor -- I'll try to recommend something.
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AI Wessex
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Tom, so you have a privileged account that you are using to get the estimates? I ask because I would like to do some investigating for my daughter. I have a lot more patience to try different approaches than she does.
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cherrypoptart
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Let's say 77077 zip and my family has never used more than 3500 dollars in a year for medical bills and that was for two childbirths so I think I'd just go with the cheapest plan which I suppose would be disaster type coverage like for a heart attack, stroke, or cancer. Thanks for making the effort. When I filled out my taxes with the H&R Block free program it said I owed $185 for my Obamacare penalty so that's what I paid but I didn't know the number to use to see if the Obamacare plan I was supposed to pick would be more than 8% of our annual income (let's say 53k, "luckily" our stocks don't pay any dividends so they don't count for income unless we sell). That's only $4240 so I'm probably one of those who can get my penalty back from the IRS. Perhaps. I heard the IRS actually knows there are a lot of people who deserve to have their penalties refunded and they know who they are but they aren't going to really act on it. It would be worth it though to fill out an adjustment.
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AI Wessex
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I missed the edit window, but my cell phone did a bit of mischief. I meant to write: "Tom, do you have a privileged account that you are using to get the estimates?" etc.
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TomDavidson
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Al: sadly, I no longer do. I'm no longer working for an insurer. But I know how to game the system a bit.

cherry: Hm. That ZIP code appears to have some grim insurance options, especially for people who just need disaster insurance. If you make more than ~$100K a year as a family, you won't be able to avoid paying a penalty for having no insurance; the cheapest plan in your area for your family is $594 a month. (I wouldn't recommend that one, though, since for $5 extra per month you can get a plan that would save you considerable money in the event of an actual hospital stay.) If your actual reported income is only $53K, then things look much better. Not only do you not have to pay a penalty for a lack of insurance, but that $594/month becomes $121.

At that rate, I'm on the fence. I definitely would normally advise someone with a family in excellent health and an income of over $100K to suck it up and pay the penalty. But for $126 a month, you can get a plan that reduces your total possible medical exposure (within limits, of course; all modern insurance has catches and gotchas, which annoys me to no end) to $6K per person. That's potentially a huge buffer against life-destroying medical costs.

That said, if you have substantial savings or wealthy family or some other way to avoid being financially destroyed by a major medical emergency, I'd just get your money back from the IRS and pay into a medical savings account. If not, find the cheapest insurance that gives you free or dramatically reduced costs after the deductible and a deductible that's low enough for you to bear.

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Seriati
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quote:
Originally posted by Greg Davidson:
Seriati, overall health care cost growth in the US has slowed under Obama. And economic growth has improved dramatically from the terrible state it was in when Obama came into office. So, what is the evidence for your "FACT that the economy slowed over all"?

Greg, the economy growth rate under Obama is slower than historical averages, when you compare the slowing in health care costs to that trend (and factor in the other things I mentioned), what you're trumpeting as a victory for Obama looks pretty much like nothing. It's just beta, there's no Alpha being created by this Administration's policies.

If the economy begins growing at its historical rate again, the illusion that is the lowered "healthcare costs" will disappears entirely, as healthcare costs grow in line with the economy. Why would should a President get credit for pretending the statistical noise in his favor is an achievement, and the noise against him has nothing to do with him?

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NobleHunter
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quote:
Why would should a President get credit for pretending the statistical noise in his favor is an achievement, and the noise against him has nothing to do with him?
What? And rationally evaluate the performance of a President? How are we supposed to be sure we get the right answers?
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Greg Davidson
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quote:
Greg, the economy growth rate under Obama is slower than historical averages, when you compare the slowing in health care costs to that trend (and factor in the other things I mentioned), what you're trumpeting as a victory for Obama looks pretty much like nothing.
Seriati, show your math. Until you do, you are just posturing.

I comprehensively demonstrated that those here criticizing Obamacare had a terrible track record for wrong predictions. I showed my sources and my analysis. Remember, Obamacare opponents uniformly said that things would get much worse when regulations increased as part of the effort to provide everyone with additional coverage and to give tens of millions of uninsured people health care coverage. You don't have to take my word for it, the comments are in this very thread.

The reduction in the growth rate in health care costs has been dramatic. The economic growth rate was affected by the worst economic collapse since the Great Depression, but has been recovering better than the rest of Europe. You raise an assertion that the current trends are statistical noise. Based on your track record on this topic, there is no basis for believing your assertion unless you demonstrate that claim with analytical rigor (not just cherrypicking, but considering a range of factors on both sides, as I did in this very thread when I was evaluating everyone's predictions).

[ October 02, 2015, 12:34 AM: Message edited by: Greg Davidson ]

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Seriati
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quote:
Originally posted by Greg Davidson:
quote:
Greg, the economy growth rate under Obama is slower than historical averages, when you compare the slowing in health care costs to that trend (and factor in the other things I mentioned), what you're trumpeting as a victory for Obama looks pretty much like nothing.
Seriati, show your math. Until you do, you are just posturing.
Which math? Have you looked at any source for growth of the economy by year? I'm interested what source you think paints a different picture. What measure shows that the change in healthcare spending is not in line with the change in spending overall?
quote:
I comprehensively demonstrated that those here criticizing Obamacare had a terrible track record for wrong predictions.
I think you showed, exactly what I said, making specific predictions is a fools errand. Picking one possibility out of an infinite number of possible results is never going to be a high percentage game.
quote:
I showed my sources and my analysis. Remember, Obamacare opponents uniformly said that things would get much worse when regulations increased as part of the effort to provide everyone with additional coverage and to give tens of millions of uninsured people health care coverage. You don't have to take my word for it, the comments are in this very thread.
I've read the thread, end to end, more than once. I get you feel vindicated, but you haven't demonstrated the correctness of your own positions in your efforts.
quote:
The reduction in the growth rate in health care costs has been dramatic. The economic growth rate was affected by the worst economic collapse since the Great Depression, but has been recovering better than the rest of Europe. You raise an assertion that the current trends are statistical noise.
Yes, that's my suspicion. It's almost impossible to verify cleanly, because no good source exists that reasonable compiles all costs of the new product in a manner that the "sides" can agree on. It's absolutely clear that general economic slowdown and slowdown in consumer spending correlate to the slowdown in healthcare spending. It's absolutely clear that government subsidies have increased, increasing the overall tax burden and hidden costs of the system. Its absolutely clear that only those seeking to deceive site to the growth rate of premiums as relevant (given that its manipulated by the government) as evidence of slower growth (it could however be evidence of the opposite).

It's debatable but a reasonable position that a portion (perhaps significant) of wage stagnation may be directly linked to increases in healthcare costs of employers (it's not debatable that there is a known correlation between increases/decreases in salary versus decreases/increases in benefits).

The only part that is actually opinion, is whether there is a left over bit that represents Beta, and which direction it points. You don't get credit for Alpha though, period, end of story.
quote:
Based on your track record on this topic, there is no basis for believing your assertion unless you demonstrate that claim with analytical rigor (not just cherrypicking, but considering a range of factors on both sides, as I did in this very thread when I was evaluating everyone's predictions).
Really, what track record are you basing this on? I've demonstrated more than one of your claims as overblown, and not actually been refuted on my claims. Is that the track record you're referring to?
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Rafi
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quote:
Originally posted by LetterRip:
Elmedorfs answer was wrong - reduced labor only lowers growth IF labor is close to capacity OR it results in a shortage of a particular labor niche.

We have such a massive oversupply of labor there is no reason to anticipate this will happen.

Also Ryan has pretty big misunderstandings of economics it will likely increase people 'joining the middle class' in that it will provide more employment opportunities for those who want/need to work.

Also Kline misunderstands the report - he talks about it 'destroying full time jobs' - it should create more full time jobs based on this finding - since individuals will reduce overtime hours worked resulting in increased total employment both part time and full time.

And now:
quote:
ObamaCare will reduce work hours equivalent to 2 million jobs in the next decade amid a host of incentives not to work or to work less, a new Congressional Budget Office (CBO) report says -- the latest blow to President Obama’s signature health insurance plan.

The report estimates the Affordable Care Act, or ACA, will make the labor supply shrink by 0.86 percent in 2025. This amounts to a shrinkage equivalent to approximately 2 million full-time workers.

I think you may not have a very good handle on this.
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D.W.
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Are these hours that bring these workers under a "typical" work week such that they are at or slipping below "full time employment"? Or is this a reduction in hours to those who are sleep deprived on mandatory overtime and at risk of making mistakes because of it when patient well being is on the line?

Not trying to be all defensive, but that snip of data could mean at least 2 (and probably more) very different things depending upon the lens it's viewed through.

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NobleHunter
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I've never understood why reducing work hours is bad thing when it's people choosing not to work.
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ScottF
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I'd love to reduce the hours I work but it's outweighed by maintaining the standard of life I've chosen.

If [insert benefactor here] were to remove that particular obstacle for me I'd likely choose to work on my golf game instead.

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Pyrtolin
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quote:
Originally posted by NobleHunter:
I've never understood why reducing work hours is bad thing when it's people choosing not to work.

Most of it is people who can now afford to retire because they're not dependent on their employer for health insurance. A fair number of them actualyl plan to continue working, but on a self-employment/entrepreneurial basis, and so aren't counted for the basic employment numbers.
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Rafi
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quote:
Originally posted by NobleHunter:
I've never understood why reducing work hours is bad thing when it's people choosing not to work.

Ever been paid by the hour?
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NobleHunter
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Fine, I'll play.

Yes.

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